Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Lancaster city, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars every year. Although many medical service providers and drug companies are ethical and work within the system, there are those who do not. When fraud happens, everyone loses. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to submit claims on behalf of the government to report this type of fraud.

The state and federal government put a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government counts on regular folks in Pennsylvania to come forward and to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Lancaster city, Pennsylvania

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the market. We know that coming forward is not easy and many things may be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work relentlessly with both you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Lancaster city, Pennsylvania

While taxpayers help fund Medicaid to permit low-income health care for those who require it, there are unethical individuals and companies who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have cost the government countless dollars. State resources dedicated to the discovery of scams are restricted and, subsequently, the state needs to rely on healthcare providers and private citizens to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, individuals who are aware of fraudulent activity versus the government have the ability to submit a whistleblower suit to hold these parties liable. Under the Act, a person who brings a whistleblower claim is entitled to a benefit between 15 percent and 25 percent of any recovery, based upon their understanding and contributions. If the government picks not to intervene in the action, the whistleblower might receive between 25 and 30 percent of the financial recovery.

 

Whistleblower laws offer included staff member protection to avoid a company from retaliating, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Lancaster city, Pennsylvania

Violations under the federal False Claims Act may result in fines and penalties in the amount of 3 times the damage to the government along with additional penalties of up to $5,500 to $11,000 for each offense.

Statute of Limitations in Lancaster city, Pennsylvania

Under the federal False Claims Act, a whistleblower claim should be started within 3 years of the date of discovering the deceitful activity and within 6 years after the activity happened, whichever took place later on, however not more than 10 years after the activity took place.

Dealing with an Experienced Whistleblower Attorney

If you suspect fraudulent activity as it concerns the Medicaid program in Lancaster city, Pennsylvania, getting guidance from a knowledgeable whistleblower lawyer is important. At Khurana Law Firm, P.C., we will help you identify if you have a valid whistleblower claim and help you understand your rights and alternatives. Contact us for a confidential, no-cost assessment to discuss your case.

What is

Medicare Advantage Fraud

Medicare Advantage (MA) plans are privately run healthcare options offering Medicare-eligible individuals additional services that are not included in traditional Medicare. These organizations receive payment from Medicare for each of their members that vary according to their risk adjustment. Some Medicare Advantage organizations overestimate and exaggerate a member’s risk or a patient’s diagnoses to get higher payments from Medicare. They do this by:

Upcoding

The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.

Chart reviews

The MA provider reviews charts to add additional diagnosis codes.

Chart mining

The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.

Adding unsupported diagnosis

Coders are directed to add codes based on other information in the chart.

Not removing old diagnosis codes

The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.

Sham RADV audits

The MA provider reviews charts to add additional diagnosis codes.

Incentivizing doctors

The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.

Pre-filling charts

Coders are directed to add codes based on other information in the chart.

If you suspect Medicare Advantage Fraud, you are a healthcare worker in Lancaster city, Pennsylvania, get in touch with us here.

Khurana Law Firm, P.C.
Medicare Fraud
Medicare Fraud is a Serious Problem

While there are no exact figures concerning Medicare fraud, we do know it is a huge problem. In the fiscal year 2020, the government recovered over $1.8 billion in civil and fraud claims relating to the healthcare industry. 

$ 0
Recovered only in 2020
YOU, the healthcare worker, provide the most vital role in combating Medicare abuse and fraud.

Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.

So what is Medicare Fraud?

Fraud, as it relates to Medicare, is when individuals or entities make false statements or representations to benefit themselves at the expense of the Medicare program. 

Who defrauds Medicare?

Medicare fraud can involve numerous individuals, organizations, and entities, including physicians and nurses, physician-owned groups, drug companies, home health providers, medical device providers, nursing homes, and others.

How do people and companies commit Medicare fraud?

Fraud and abuse come in many different forms from coding abuses, to kickbacks, to altering records, to organized crime infiltration. Each method benefits the abuser while costing taxpayers billions. 

What laws protect Medicare from fraudulent activity?

The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity. 

What government agencies protect against Medicare fraud?

Many government agencies strive to protect and promote the integrity of Medicare. These include the Centers for Medicare and Medicaid Services, Center for Program Integrity, US Department of Health and Human Services, and US Department of Justice, all attempting to keep Medicare fraud at bay. But they rely on people like YOU to be their eyes and ears.

How can I help?

If you see abuse and fraudulent activity you should report it. In some cases, you may even be entitled to a reward. If you are a healthcare worker in Lancaster city, Pennsylvania,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Lancaster city, Pennsylvania

When you become aware of potential fraud that may involve Medicaid or Medicare in Lancaster city, Pennsylvania, you need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is fully examined and filed accurately and quickly. By working with a skilled lawyer you are increasing the chance that the government will step in, therefore increasing the chance for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam legal representatives to assist in your fight against Medicare and Medicaid scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam claim to help report the fraud and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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